Join us for "Mediation Boot Camp" 
Learn practical skills, strategies & techniques to become an effective mediator. 
April 16th & 17th Augusta, GA and April 20th & 21st Macon, GA
$895 per person
Discount for two participants from the same organization
Practicum Dates and Times TBA
Observe 5 General/Civil cases lead by a GODR registered Mediator ($80 per mediation session) OR Attend a 12 hour Practicum $395 per person

Name
first last
Title
Company
Address
street line 1
street line 2
, city, state/prov zip
Email
Phone
Fax
Name as you would like for it to appear on your certificate (Required)
I am interested in becoming a mediator because...
I intend to register with the Georgia Office of Dispute Resolution
Yes
No
Undecided
   (R)
I am interested in working in the following categories /areas
Commercial/Civil/General
Commercial
Community
Construction
Contracts
Divorce/Family/Marital/
Education/Teacher-Admin/Parent-Admin./Peer Mediation
Equal Employment Opportunity Commission
Engineering
Entertainment
Estates/Probate/Trusts/Trust Management
Healthcare/Medical/Eldercare
Labor/Management
Landlord/Tenant
Land Use
Partnership/Dissolution/Succession
Legal Malpractice
Personal Injury
Professional Fees
Public Policy/Gogernment Agency
Real Estate
International/Cross cultural
Special Education 504
Workers Compensation
Tax
Parenting Plans
Technology/Intellectual Property
Child Support
Workplace/Human Resources/Employment
Associations/Organizations
Victim Offender/Criminal
Online Mediation
Experience in the following areas
I would like to participate in the Program to Counter Community Violence
Yes
No
Would like more information on the project
Not sure, will decide later

Note: Please do not include any URLs in form.





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